Surgical instrument.



' PATENTED MARiIIO, 1903.

N. J. SMEDLEY. SURGICAL INSTRUMENT. APPLICATION IILEDMAB. 22, 1902.

NOVMODEL.

PATENT OFFICE.

NATHAN J. SMEDLEY, OF CHICAGO, ILLINOIS.

SURGICAL INSTRUMENT.

SPECIFICATION forming part of Letters Patent N 0. 722,542, dated March 10, 1903.

Application filed March 22, 1902. Serial No. 99,406. (No model.)

To all whom it may concern."

Be it known that I, NATHAN J. SMEDLEY, M. D., of Chicago, in the county of Cook and State of Illinois, have invented certain new and useful Improvements in Surgical Instruments; and I hereby declare that the following is a f u1l,c1ear,and exact description there-v 'of, reference being had to the accompanying drawings, which form part of this specification.

My invention relates to improvements in surgical instruments, andit has especial referenceto douche-tubes for treating and cleansing theyagina and uterus.

The object of my invention is to provide an instrument for dilating, treating, and cleansing the vagina and uterus of all objectionable accumulations, for the local medication of these parts, and for removing and rendering harmless the otherwise retained diseased germs and objectionable matter.

With these and other objects in view,which will be obvious to those skilled in the art from the description hereinafter, my invention consists in the features, details of con.- struction, and combination of parts, which will first be described in connection with the accompanying drawings and then particularly pointed out in the claims.

In the drawings, Figure 1 is a perspective view of the grooved spiral douche-tube in-V inserted withina dilating-speculum in position to be used. Fig. 2 is a grooved spiral douche-tube having a bandage of medicated gauze wound around its cochleated end. Fig.

3 is an elevation of a dilating-speculum, in which the douche-tube may be inserted. Fig. 4: is an end view of the same.

Figs. 3 and 4 represent the dilator, which is a convenient attachment in the use of my improved douche-tube.

In the drawings the same numerals of reference indicate similar parts.

1 represents the fluted or grooved shaft of the douche-tube.

2 is the cochleated or spiral terminal of the same, forming a skeleton expansion of the shaft, having an unobstructed axial passage.

3 isthe inlet for the entrance of the fluid into the douche-tube.

4 at are the outlets for the exit of the fluid from the douche-tube. These are six in number, arranged in a circle near the outer end of the douche-tube and in the respective grooves.

5 5 is a series of longitudinal parallel grooves in the exterior surface of the tubeshaft for the exit from the uterus of escaping fluid along and through these grooves or troughs.

6 is a handle joining the shaft.

7 is a hose-coupling for the attachment of the fluid-supply hose. 7

8 is a swivel upon which the supply-hose rest when the instrument is revolved, so that the hose will not be twisted by that operation.

9 is a bulbous pear-shaped tip for protecting the organs from violence and for facilitating the entrance of the instrument by dilating the 0s uteri in entering the uterus, so that the shaft of the douche-tube will not bind when being rotated. i

There are three dilators of as many different sizes supplied with this instrument, all of which are interchangeably attachable to the cochleated end of the instrument.

10 and 11 are two dilators of the three,each adapted to fit on the end of the instrument and also to serve as a means for turning the instrument in place in the position shown. The dilators or tips 10 and 11 when in the positions shown also serve as a gage for indicating the distance of insertion, and are used as a lover or handle for the forcible rotation of the shaft of the douche-tube.

12 12 are the spaces Within the helicallyformed tube.

13 is a stop-cock for cutting off the supply of fluid into the douchetube. It is so arranged as to be conveniently manipulated by the thumb of the operator.

The spiral and shaft composing the douchetube is'made of six parallel'wires bound together in any convenient manner, as by welding or brazing, arranged around or forming a central tube. The shaft may also be made by rolling or crimping a tube into the shape desired.

The spiral douche-tube is accompanied by an attachment, which is an essential part of the instrument, called a vaginal dilator. (Shown in Figs. 2, 3, and 4.) It is adjustable and self-retaining for the purpose of mechanical examinations and topical applications and for cleaning the vagina by flushing.

Theinstrument is a five-valve vaginal speculum made,preferably,of five blades or valves facilitate introduction into the vagina. Each of the blades is fenestrated throughout its entire length, so as to expose a maximum of the inner surface of the vagina for inspection and treatment.

1t is a spring-pressed stirrup for holding the valve in position and by means of which the valve is rotated.

16 16 are the folded wire blades fixed into the open ring 15.

The ring 15 is provided with a central opening large enough to admit the spiral end of the douche-tube.

The spiral of the douche-tube opens the wedge-shaped vaginal dilator as it is passed from the ring 15 upwardly. When the spiral passes to the dilating end 17, it rests in five retaining-grooves, which are formed therein to receive and retain it and to permit free rotation.

The enlargement near the ends of the respective blades and the corresponding depressions just below provide a retainer to hold the device in position within the vagina when it is either closed or opened, making it a self -retaining dilator, and therefore convenient for the application of heat, refrigeration, or other treatment.

The enlargement l8 prevents the dilatorfrom entering farther than desired.

The operation of the device is as follows: For irrigating the douche-tube should be attached to a fluid-supply hose of an irrigator, fountain-syringe, or siphon-tube, leaving the hose-coupling end free to be rotated at the swivel, so that the hose will not twist on itself and obstruct the flow of fluid through it. The fluid should fill the entire tube first to expel all of the air, the stop-cock 13 should then be turned by the rearward pressure of the thumb upon the stirrup 14 into the position shown in the drawings for the purpose of shutting oif the supply of fluid into the tube, and then the tip on the cochleated end of the instrument should be inserted well back along the posterior wall of the vagina, when the tip should be rotated upward and it will pass into place for use, as the curve at the end conforms to the normal curve of the axis of the pelvis. When in position, the stop cock should be opened by pressing the stirrup forward to allow the irrigation to begin at once, as the suction of the vacuum has a tendency to fill the space in the spiral coil, and it should contain fluid and not air. The tube should then be rotated from left to right, screwing it in until all parts of the cavity are thoroughly cleansed, as shown by the character of the return flow, which passes out through the parallel fluted or grooved surfaces of the exterior of the tube. This process should be continued until medication is complete.

To remove any objectionable and diseased accumulation, the instrument should be contin ued in its rotation toward the right, when all of the loosened and undesirable matter will fall into the interior space 12 12 of the coil inclosed by the spiral. The instrument can be continued in its final rotation until the entire instrument is removed with all of the accumulation. The stop cock should then be closed; but the flow of the irrigating and medicated fluid should be allowed to con tinue during this entire process, so as to maintain the rinsing process during the time it is being operated.

The operation just described has reference to the use of the instrument within the vagina. The operation is the same when the instrument is used within the uterus. The instrument may be prepared for swabbing the cavities by passing aloop of strong thread through two of the fenestrations at the top of the tube and passing through this thread-loop a oneinch-wide strip of cloth or medicated gauze bandage and then winding the bandage around the tubing'of the spiral douche-tube, as shown in Fig. 2. This firmly secures the fabric, so that it cannot get loose in the cavity, and provides a new and useful instrument. The end of this bandage provides an additional means for dilating the os uteri by applying tension on the free ends of the bandage at an angle to the shaft.

The cochleated or spiral end of the douchetube is a means for cleaning the vagina by mechanical contact with all parts of the vaginal mucus membrane. By rotation the spiral passes over the entire lining-surface. This is believed to bea new and useful instrument for this purpose.

When the use of the douche and dilator is accompanied by the proper fiow of an irrigating fluid, plain or medicated, all of the discharges are washed into the coils-space 12 12 of the spiral and flushed out of the vagina, while the natural folds of which are held distended throughout during the mechanical contact, thus affording a means for flushing and medication and for applying heat and refrigeration directly in contact with the surface.

By inserting half of the spiral ring within the uterine cavity a spiral ejector is provided and irrigation of the uterine cavity can be easily accomplished.

By providing three tips of difierent sizes to cap the ends of the spiral tube any one of the tips best adapted for the particular case may be employed which will facilitate the introduction into the uterine cavity. These tips are made larger than the tubing and pro- .in the tube finds egress.

tect the end where the six openings 4: 4: are made into the tube,from which the fluid with- These tips perform three functions: first, as dilators; second, as

a means for protecting the openings 4: 4: from being closed, and, third, as a means when removed for providing a handle for forcibly turning the instrument, as shown at 10 and 11. Owing to the size of the tips and their peculiar shape they are dilators and protect the surface of the uterus and hold back the flow from entering the fallopian tubes.

The instrument is adapted for cleaning the uterus in any stage of its reductive metamorphosis or in its post-partum state, while the hook-shaped spiral conforms to the normal curve of the axis of the pelvis.

Having described my invention, what I claim as new and useful, and desire to secure by Letters Patent of the United States, is

1. A douche-tube comprising a cylindrical shaft of relatively small diameter bent to form astraight, extended portion, and askeleton spiral portion arranged out of axial alinement with said straight portion, whereby a relativelylarge axial area is left unobstructed.

2. A douche-tube comprising a hollow, perforated shaft, having one end bent to form a skeleton spiral, axially unobstructed, said tube being provided with exterior conduits coextensive therewith, and transverse conduits establishing communication between said exterior conduits and the interior of the shaft.

3. A douche-tube comprising a hollow, perforated shaft, havingastraight portion 1, and a spiral skeleton end portion 2, arranged out of axial alinement with the straight portion.

4. Adouche-tubecomprisingacentralfluidconduit, one or more conduits in the exterior surface thereof, corresponding passage-ways connecting the interior and exterior conduits near the end of said tube, a dilator on the end of the tube immediately in front of the said passage ways, and a folded bandage wound around said tube with its free ends accessible for manipulation.

5. Adouche-tube comprisingacentralfluidconduit, a dilator adapted to be screwed in the end of said tube,-and laterally-projecting screw-threaded studs near the handle end of said tube to receive said dilators to provide a gage on said tube.

6. A douche-tube comprising a central conduit, provided with a series of longitudinal parallel grooves on the exterior surface thereof, a dilator on the end of said tube, openings between the exterior and interior conduits immediatelyin the rear of said dilators, a handle on the opposite end of said tube, a swivel water connection on the end of the handle, a lateral extension from said tube near the handle to provide a gage, and a means for rotating the tube, and a stop-cock intermediate of said gage and said handle.

7. A douche-tube comprising a hollow shaft, a removable dilator, adapted to be screwed on the end of said shaft, laterally-projecting screw-threaded studs near the handle end of said tube adapted to receive said dilators, and two or more dilators of varying sizes secured to saidtube in the manner set forth.

8. In a douche-tube a dilator 9 removably fixed to the end of said tube, removable dilators 10 and 11 screwed to lateral projections from said tube near the handle, and the handle 6.

In testimony that I claim the foregoing as my own I affix my signature in presence of two witnesses.

NATHAN J. SMEDLEY.

In presence of FoRnE BAIN,

MARY F. ALLEN. 

